What Is Acromegaly

Characterized by the excessive production of growth hormone (GH), this clinical picture, which results in bone deformation in adults, can appear in childhood, being called Gigantism. In these cases, contrary to what happens in the older age groups, children develop a great stature.  

Acromegaly usually occurs between 30 and 50 years of age at a time when the growth plates are already closed. Thus, unlike gigantism, which is characterized by abnormal bone growth, Acromegaly slowly leads to deformation. On the other hand, and since the excess of growth hormone affects all organs and tissues, they grow larger than normal and become thicker giving rise to several complications.

This is a rare condition that affects three people in 1 million every year.

Causes

In about 90% of cases, the excessive production of growth hormone results from a (benign) tumor of the pituitary gland, known as adenoma.

More rarely, other rare tumors of the pancreas and lungs can lead to the production of hormones that stimulate the pituitary gland to produce excessive amounts of growth hormone.

Symptoms

  • Protruding jaw
  • Protruding forehead
  • Creased wrinkles
  • Big nose
  • Thick lips
  • Hoarse voice
  • Excessive sweating
  • Oily skin or acne
  • Irregular menstrual cycles (in women)
  • Vision changes
  • Head and joint pains
  • Tiredness
  • Tingling in the upper and lower limbs
  • Cardiac insufficiency

Between 10 and 25% of cases are affected by diabetes. About 25% of patients have hypertension and in 80% there is a change in blood glucose. Breast enlargement, sexual disinterest and sexual impotence can also be seen in men.

These patients are even more likely to develop a tumor (in most cases benign) polyps in the colon, goiter and enlarged prostate.

Diagnosis

Acromegaly is, in the vast majority of cases, diagnosed a few years after the first symptoms appear.

The diagnosis is confirmed by a blood test that confirms elevated levels of growth hormone and insulin-like growth factor 1 (IGF-1).

It may also be necessary to order a computed axial tomography (CT scan) to detect abnormal growth of the pituitary gland.

Treatment

The treatment of Acromegaly can be done with the combination of surgery, radiation therapy or with the use of drug therapy.

  • Surgery: it is considered to reduce the tumor that originated in Acromegaly. However, these tumors are often large at the time they are diagnosed and surgery alone does not cure this condition. In these cases, radiotherapy is used as a complementary treatment, especially if a substantial amount of tumor remains after surgery and Acromegaly persists.
  • Radiotherapy: Radiotherapy involves the use of irradiation by supertension, being less traumatic than surgery. However, it takes longer to take effect and can still affect normal tissue.
  • Drug therapy: in order to decrease the levels of growth hormone, some drugs are prescribed that block or inhibit the production and secretion of this hormone.

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